Abstract: Described here are devices and methods that may facilitate treatment of a calcified heart valve with shock waves. A shock wave valvuloplasty device may be advanced through a patient's vasculature and self-align with cusps of a calcified aortic valve. Alignment may be facilitated by a central anchor and/or U-shaped distal bends of positioning wires. An elongated carrier may be slidably disposed over a portion of the positioning wire and carry one or more electrode assemblies that may generate shock waves. An inflatable balloon may sealably enclose the electrode assembles, and shock waves may propagate through the liquid-filled balloon and transfer energy to adjacent calcified valve cusps. The shock wave valvuloplasty device may comprise one or more features to direct shock waves to specific areas of calcified tissue. Some variations also comprise a central anchor configured to be positioned below the valve leaflets.